O efeito da auriculoterapia e do exercício físico resistido sobre o estresse oxidativo e na qualidade de vida de pacientes renais crônicos submetidos à hemodiálise

Abstract

Oxidative stress and loss in quality of life are common findings in patients with chronic kidney disease on haemodialysis and are associated with the development of other pathological processes, as well as in the progression of the disease itself. The objective of the present work was to evaluate the effect of auriculotherapy and resistance exercise, associated or not, as nonpharmacological therapies on the oxidative profile, on the clinical management of routine biochemical tests, and on the quality of life of chronic renal patients undergoing hemodialysis treatment. The sample was divided into 4 groups: Control Group, Auriculotherapy Group, Resistance Exercise Group, Auriculotherapy+Resistance Exercise Group. The levels of Protein Thiols (PSH), Non-Protein Thiols (NPSH), Superoxide Dismutase (SOD) activity, Vitamin C, Myeloperoxidase (MPO) activity, Thiobarbituric Acid Reactive Species (TBARS) and Creactive protein were analyzed before and after the interventions in order to assess the oxidative profile. To evaluate the effect of the interventions on biochemical patterns, medical record data on monthly GFR, albumin, 25-hydroxyvitamin D, calcium, creatinine, glucose, HDL, LDL, potassium, sodium, urea, and post-session urea tests were used. Quality of life was analyzed by the 36-item Short Form Survey (SF-36). For the statistical analyses the Shapiro-Wilk normality test and the Dixon test for outliers were used, followed by the Willcoxon test and two-way Anova using the Statistica® 8.0 software (STATSOFT). Regarding the antioxidant components, Vitamin C levels increased (p≤0.05) after the interventions of resistance exercise and association between auriculotherapy and resistance exercise. The antioxidant activity of SOD increased (p≤0.05) with all the proposed treatments. The levels of NPSH were decreased (p≤0.05) in all groups. Markers of oxidative damage were decreased (p≤0.05) in the resistance exercise groups and in the association between auriculotherapy and resistance exercise with regard to MPO activity. In the auriculotherapy and association between auriculotherapy and physical exercise groups there was a decrease (p≤0.05) in TBARS levels. Some biochemical components were altered after the treatments, where the auriculotherapy protocol triggered the decrease (p≤0.05) in Glucose and Sodium values and the increase (p≤0.05) in GFR and Albumin values. The resistance exercise protocol promoted decrease (p≤0.05) in Albumin and Sodium values and increase (p≤0.05) in GFR. The association between auriculotherapy and resistance exercise was responsible for the decrease (p≤0.05) in Albumin, Sodium and Urea values. Quality of life aspects improved (p≤0.05) in all intervention groups, emphasizing the association between auriculotherapy and resistance exercise that had an impact on all components. The application of auriculotherapy and resistance exercise treatments in hemodialysis patients promoted protection on oxidative stress, changed biochemical patterns and for more also served as tools for increasing perceived quality of life.